Crohn's Disease

Crohn’s disease is a long-term condition that causes swelling and irritation in your digestive tract. It’s one of the main types of inflammatory bowel disease (IBD).

Crohn’s happens when your immune system overreacts and attacks your digestive tract, causing inflammation. Symptoms can range from mild to severe.

For some people, Crohn’s disease can be debilitating. Ongoing inflammation may lead to frequent bathroom trips, pain, fatigue and time away from work or school.

Crohn’s is a lifelong condition. But treatment can help you manage symptoms, reduce inflammation and live an active life.

Types of Crohn’s disease

Crohn’s can affect any part of your digestive tract, from your mouth to your anus. Some people have Crohn’s in more than one area of their digestive tract. Healthcare providers often describe the disease based on where swelling and irritation occur.

Types include:

• Ileocolitis: Affects the end of your small intestine (ileum) and your large intestine (colon) — this is the most common type
• Crohn’s colitis: Limited to your large intestine
• Ileitis: Affects only the last part of your small intestine (ileum)
• Gastroduodenal Crohn’s disease: Affects your stomach and the start of your small intestine (duodenum)
• Jejunoileitis: Patchy areas of swelling in the upper part of your small intestine (jejunum)

These types describe where Crohn’s affects your body. But your symptoms and treatment may be similar.

Crohn’s disease symptoms

Symptoms of Crohn’s disease may develop slowly over time or come on suddenly. They may be mild to severe.

Some people have long-term (chronic) symptoms until treatment helps manage them. Other people have symptoms that come and go. You may have periods when the disease is active (flares) and times when you feel better (remission).

In more severe cases, symptoms can interfere with your daily life. They can make it difficult to work, go to school or keep up with normal routines.

Signs of Crohn’s disease include:

• Belly pain or cramps
• Ongoing diarrhea
• Feeling very tired
• Loss of appetite
• Unexpected weight loss
• Fever
• Blood in your poop
• Mouth sores

Crohn’s can also affect other parts of your body. You may notice signs and symptoms like:

• Joint pain
• Skin rashes
• Eye irritation
• Liver or bile duct swelling
• Kidney stones
• Bone loss

In children and teens, Crohn’s may delay growth or puberty.

What causes Crohn’s disease?

Researchers don’t know the exact cause of Crohn’s disease. But they believe it may be due to a combination of your immune system and your genes.

In Crohn’s disease, your immune system overreacts. Normally, your immune system protects you from harmful germs. But with Crohn’s, it attacks harmless bacteria in your gut. This causes swelling and irritation.

Genetics may also play a role. Crohn’s sometimes runs in biological families. Certain genes may increase your risk. But many people with Crohn’s have no family history of the condition.

Risk factors

Anyone can develop Crohn’s disease. But some factors raise your risk, including:

• Age: Healthcare providers most often diagnose Crohn’s in teens and young adults ages 15 to 35.
• Biological family history: If a parent, sibling or child has Crohn’s, your risk may be higher.
• Smoking: Smoking increases your risk and can make symptoms worse.
• Ethnicity: Crohn’s is more common in people of Northern European descent.
• Certain medications: NSAIDs like ibuprofen (Advil®) and naproxen (Aleve®) don’t cause Crohn’s, but they can worsen symptoms.

Complications of Crohn’s disease

Crohn’s can sometimes lead to serious complications that may need extra treatment or surgery. Without treatment, these complications can affect your quality of life.

One example is a fistula. Fistulas are abnormal tunnels that form between parts of your body that don’t usually connect. In Crohn’s, they often develop around your anus and may cause pain, swelling, or leakage of pus or poop.

Other complications may include:

• Abscesses: Infected pus-filled pockets in your belly or near your anus
• Anal fissures: Small tears in the lining of your anus
• Strictures and blockages: Scarring that narrows your intestines, leading to blockages
• Malnutrition: Vitamin or mineral deficiencies because your body can’t absorb nutrients
• Anemia: Low red blood cell level from bleeding or poor nutrient absorption
• Colorectal cancer: Cancer in your colon or rectum

Not everyone with Crohn’s disease develops these complications.

How doctors diagnose Crohn’s disease

There isn’t one test to diagnose Crohn’s disease. A healthcare provider will use a combination of tests to look for inflammation and rule out other conditions.

Your provider will start by asking about your symptoms, medical history and biological family history. They’ll also do a physical exam. They may refer you to a gastroenterologist (a doctor who specializes in digestive diseases).

Tests used to make a Crohn’s disease diagnosis may include:

• Blood tests: These tests check for signs of irritation, infection or anemia.
• Stool tests: A sample of your poop can help find inflammation or infection in your intestines.
• Colonoscopy: Your provider uses a thin tube with a camera to look inside your colon and the end of your small intestine. They may also take small samples (biopsies) of your intestines to confirm the diagnosis.
• Imaging tests: CT or MRI scans show detailed images of your digestive tract.

Your provider will review the results to confirm Crohn’s disease or rule out other conditions.

Crohn’s disease treatments

There’s no cure for Crohn’s. But treatment can reduce inflammation, relieve symptoms and help you stay in remission. Without treatment, the condition can worsen over time and lead to more serious symptoms or complications.

Your healthcare provider will make a plan based on:

• How severe your disease is
• Which parts of your digestive tract it affects
• How you respond to treatment

Your provider may recommend medications, nutrition therapy and/or surgery.

Crohn’s disease medication

Most people take medicine to reduce inflammation or calm their immune system. These medications reduce your risk of flares and complications.

Types of medications to treat Crohn’s disease include:

• Corticosteroids: Corticosteroids quickly reduce inflammation during a flare. They work more as a bandage to get you on the right long-term medication and treatment.
• Immunomodulators: This type of medicine calms your immune system.
• Biologics: Biologics target specific parts of your immune system that cause inflammation.
• JAK inhibitors: JAK inhibitors reduce immune system activity.
• Antibiotics and other medications: Other medications kill harmful bacteria, treat diarrhea or manage pain.

Your provider will monitor your response and change your medications as needed.

Nutrition therapy

Crohn’s can make it harder for your body to absorb nutrients. To help prevent malnutrition, your provider may recommend:

• Making changes to what you eat
• Taking supplements
• Starting a specialized meal plan
• Using a feeding tube in severe cases

Surgery

Medications work for many people. But you may need surgery if complications develop or symptoms don’t improve with treatment. Surgery for Crohn’s disease can treat problems like:

• Bowel blockages
• Fistulas
• Abscesses
• Severely damaged parts of your intestine

Surgery can improve symptoms and treat complications, but it doesn’t cure Crohn’s disease. You may still need medication after.

When should I call my healthcare provider?

Contact a healthcare provider if you notice symptoms of Crohn’s. They’ll run tests to find out what’s going on.

If you’ve been diagnosed with Crohn’s, reach out to your provider if you:

• Have new or worsening symptoms
• Think you’re having a flare
• Feel like treatment isn’t working
• Notice blood in your poop
• Have continued diarrhea or belly pain
• Have fevers or concern for infection
• Lose weight without trying

Seek immediate care if you have severe belly pain, signs of a blockage (like vomiting or not passing gas or poop) or heavy bleeding.

What’s the outlook for people with Crohn’s disease?

There’s currently no cure for Crohn’s disease, and outlooks vary. Some people have mild symptoms. But for others, the disease is severe. They may require ongoing treatment or surgery.

Crohn’s disease isn’t usually life-threatening. Life expectancy is generally normal. But ongoing inflammation can increase your risk of colon cancer and cause other complications.

Regular check-ups and screening tests, like colonoscopies, can monitor your health and catch problems early. Treatment can help manage irritation and reduce symptoms. Most people with Crohn’s disease can live full, active lives.

Can Crohn’s disease be prevented?

You can’t prevent Crohn’s disease. But you may be able to reduce flare-ups and manage symptoms. These self-care tips may help:

• Quit smoking: Quitting can reduce flare-ups and your chance of complications.
• Avoid medicines that bother your gut: Some medicines, especially NSAIDs, can trigger symptoms.
• Pay attention to foods that trigger symptoms: Some foods may worsen your symptoms, so you may want to keep a food diary.
• Eat smaller, balanced meals: Eating easy-to-digest foods more often may help reduce symptoms during flares.
• Manage stress: Getting regular physical activity, enough sleep and mental healthcare can help.

Work with your provider or a dietitian to create a plan that fits your needs.